Lipitor Side effects in Females (Pfizer’s Atorvastatin)

Most Lipitor side effects in females are identical to those in men. However, some side effects are more commonly seen in women than men.

Lipitor’s most important side effects are related to muscle and liver injury. Hence, it is contraindicated in patients with active liver disease.

Women are more prone to develop certain side effects such as irregular menstrual cycles and hormonal changes.

The efficacy of Lipitor in lowering LDL, Triglycerides, and Total Cholesterol, and increasing HDL in women vs men has been found to be comparable.

In one study, it was found that low-dose Lipitor (10 mg) more effectively reduced LDL in women compared to men. In contrast, high-dose Lipitor was more effective in men than women.

What is Lipitor?

Lipitor is a high-potency statin drug. The generic drug is Atorvastatin which is an HMG-CoA inhibitor. Lipitor blocks the synthesis of cholesterol in the liver by blocking the key rate-limiting enzyme, HMG-CoA reductase. Thus it blocks the synthesis of new cholesterol molecules.

It also increases the LDL receptors on the surface of hepatocytes, enhancing the removal of circulating cholesterol (LDL and VLDL) from the plasma.

The FDA has approved Lipitor (Atorvastatin) for the following conditions [Ref]:

• To reduce the risk of myocardial infarction, stroke, and atherosclerotic cardiovascular conditions in patients who are at risk (in addition to diet and exercise).
• Treatment of hyperlipidemia to reduce Total Cholesterol, LDL, VLDL, and Triglycerides, and increase HDL (good cholesterol) in patients with homozygous, heterozygous, or mixed familial hyperlipidemia.
• In girls who have started menstruating and boys 10 to 17 years of age with familial heterozygous hypercholesterolemia who have an LDL of more than 190 mg/dl or more than 160 mg/dl along with any of the following risk factors:
  • a family history of premature cardiovascular disease
  • the presence of two or more CVD risk factors in the pediatric age group.

What are the side effects of Lipitor?

Lipitor side effects are enlisted here based on the severity of side effects:

• Severe Side Effects:

  • Muscle pain, weakness, or tenderness suggestive of rhabdomyolysis
  • Liver problems (hepatitis) manifest as jaundice, abdominal pain, and dark urine.
  • Allergic reactions, such as hives, swelling, or difficulty breathing

• Moderate Side Effects:

  • Digestive problems, such as nausea, diarrhea, or constipation
  • Headaches or dizziness
  • Insomnia or sleep disturbances
  • Increased blood sugar levels

• Mild Side Effects:

  • Joint pain or swelling
  • Rash or itching
  • Flatulence or bloating

Lipitor side effects are enlisted here based on the system involved:

• Gastrointestinal System:

  • Abdominal pain
  • Constipation
  • Diarrhea
  • Flatulence
  • Nausea
  • Vomiting

• Musculoskeletal System:

  • Muscle pain
  • Muscle weakness
  • Joint pain
  • Joint swelling

• Nervous System:

  • Headache
  • Dizziness
  • Insomnia
  • Peripheral neuropathy

• Skin and Appendages:

  • Rash
  • Pruritus (itching)
  • Urticaria (hives)

• Hepatic System:

  • Hepatitis (inflammation of the liver)
  • Elevated liver enzymes

• Hematologic System:

  • Thrombocytopenia (low platelet count)

• Endocrine System:

  • Increased blood sugar levels

Lipitor Side effects in Females Vs Males

Women are more likely than men to develop certain side effects using Lipitor. In a survey when women were asked a few questions about statins, the following responses were obtained from women vs men [Ref]:

Females are more likely to develop side effects compared to men. Approximately half of the women (50%) on statins develop side effects vs 40% of the men.

In addition, women are more likely to discontinue statins because of side effects (7.9% women vs 3.6% men).

Lipitor-associated muscle disease in females vs males:

The most commonly reported side effects of statins are muscle pains, fatigue, and weakness. Women are 2.53 times more at risk of developing rhabdomyolysis compared to men.

The incidence of “definite or incipient myopathy” was seen in a great proportion of females than males (Hazard ratio of 1.8, almost two times that of males) [Ref].

Myopathy associated with Lipitor (Atorvastatin) vs Zocor (Simvastatin) was found more in females compared to males as shown in the table below [Ref]:

Some statins are more likely to cause rhabdomyolysis, myopathy, or muscle disease than others. Here is a table of comparison of the incidence of muscle disease with different statins:

Lipitor, Zocor, and Mevacor are more strongly associated with rhabdomyolysis than Crestor and Pravachol.

What to do if you develop muscle disease while taking Lipitor?

The first thing is to consult your doctor. Your doctor might reduce your dose or switch you to another statin.

You may need to take more water, eat a healthy balanced diet, and start exercising. Some patients may benefit from taking supplements like co-enzyme Q.

Statins-associated Diabetes in females vs males:

The risk of diabetes associated with the use of statins is debatable. Different studies have reported different percentages.

According to some experts, the underlying metabolic syndrome in patients with high cholesterol levels may be a contributing factor to increased diabetes risk, rather than the statins or hyperlipidemia treatment itself.

In one study, the risk of diabetes associated with statin use was found more in women compared to men ((1.53 vs 1.03 per 100 person/years) [Ref].

The following table compares the risk of incident diabetes with different statins:

How can you prevent statin-associated diabetes?

It is important to check your blood sugars before starting a statin. In addition, Lipitor may not help your cholesterol levels if you are not eating a healthy low-calorie diet.

You should restrict your diet and eat healthy vegetables, grains, and lots of fiber. Simultaneously, you must avoid drinks and beverages that have high carbs and are calorie-rich.

You must do a minimum of 30 minutes of exercise daily. In case you develop symptoms of excessive urination, thirst, or weight loss, you should immediately check your blood glucose and see your doctor.

Cancer-associated with statins in females vs males:

The risk of cancer has also been associated with statin use. In the PROSPER study, 25% of the women reported an increased risk of cancers with a great proportion of them using statins.

Among the cancers associated with statins, breast cancer, prostatic cancer, colorectal cancer, lung cancer, and pancreatic cancer are more likely associated with statins use.

The incidence of breast cancer has been seen more in women using statins 33% vs those not using statins [Ref].

In the CARE study, women in the statins group had 12 times increased risk of the incidence of breast cancer vs those not on statins [Ref].

However, recent reports have found neutral effects. In addition, most authorities advocate the use of statins stating that the cardiovascular benefits of statins far outweigh the risks.

Other rare Lipitor side effects that may be more common in females than males include:

• Anxiety
• Depression
• Memory impairment
• Numbness
• Tingling
• Gastrointestinal upset like diarrhea/ constipation, and abdominal pain.

Lipitor Efficacy in Females vs Males:

Lipitor is effective in both men and women. However, women are more likely to avoid statins and discontinue treatment compared to men [Ref]

In a cohort of more than 5000 patients, 34.5% of the women were not on statins compared to 22.2% of men despite the fact that women were more worried about having a heart attack or a stroke than men (45.7% of women vs 34.4% men) [Ref]

In a study that compared the efficacy of different statins in men vs women, it was found that Lipitor compared to other statins was more effective in women than men.

Both men and women who had stable coronary heart disease were advised 80 mg of Lipitor daily. The relative reduction of major cardiovascular events was seen in 27% of the women vs 21% of men.

In conclusion:

Lipitor is a high-potency statin. Lipitor side effects in females and males are identical, however, women are more likely to develop muscle pains and diabetes.

There have been reports of increased risk of breast cancer too but data is conflicting.